Global health Issue
ntashkan
chapter_10.pdf
Chapter Ten Child Health
The Importance of Child Health
• 8.8 million children under the age of 5 die each year • Many of these deaths are preventable • Children are a particularly vulnerable population • Closely linked with poverty • Insufficient progress has been made in certain parts of the world in reducing childhood morbidity and mortality • https://youtu.be/dwPOYtezqk0
Key Terms
• Perinatal : first week of life • Neonatal : referring to the first month of life • Infant : referring to the first year of life • Under-‐5 : referring to children 0-‐4 years old
Table 10.2: Selected Terms Relating to Causes of Child Illness and Death
https://youtu.be/Qr32JS-‐7jLY
The Burden of Childhood Illness
Children Under 5 Years • 99% of childhood deaths are in low-‐ and middle-‐income countries • Half of these deaths occur in India, Nigeria, Democratic Republic of the Congo, Pakistan, and China • 41% of under-‐5 child deaths occur among neonates • Rates and causes vary across and within countries • General trend is decline, but rates of decline also vary considerably by region
Figure 10.1: Neonatal Mortality Rate, by WHO Region, 2004
Figure 10.2: Infant and Under-‐5 Mortality
Figure 10.4: Causes of Neonatal Deaths, by Percentage, 2008
Figure 10.5: Causes of Postneonatal Deaths in Children under 5, by Percentage, 2008
Figure 10.6: Declines in Under-‐5 Child Mortality, by Region, 1990-‐2008
Additional Comments on Selected Causes of Morbidity and Mortality
Acute Respiratory Infections • Leading cause of death in low-‐ and middle-‐income countries • More severe and cause higher rates of death in low-‐ and middle-‐ income countries than in high-‐income countries • Upper respiratory tract infections include the common cold and ear infections, lower respiratory infections include bronchiolitis and pneumonia • https://youtu.be/JjbGdJxoqlM
Additional Comments on Selected Causes of Morbidity and Mortality
Diarrhea • Caused by bacteria, viruses, protozoa, and helminths • Causes dehydration, loss of nutrition or wasting, and damage to the intestines • Infants 6-‐11 months are particularly vulnerable because they have been introduced to unsafe water and foods
Additional Comments on Selected Causes of Morbidity and Mortality
Malaria • 750,000 children die from malaria each year • A child in sub-‐Saharan Africa is likely to have a case every 40 days • Associated with premature birth and intrauterine (within the uterus) growth retardation, which reduce chances of survival
Additional Comments on Selected Causes of Morbidity and Mortality
HIV/AIDS • Can be transmitted from mother to child during birth or breastfeeding • Number of HIV-‐infected children has grown, particularly in sub-‐ Saharan Africa
Additional Comments on Selected Causes of Morbidity and Mortality
Measles • Acute respiratory infection with complications including pneumonia, diarrhea, encephalitis, and blindness • Children who are vitamin A deficient or infected with HIV are more at risk of death • Extremely contagious if a population is not vaccinated
Additional Comments on Neonatal Mortality
• 41% of children under 5 who die annually, actually die in the first month • Little progress in reducing neonatal death rate • Every day that a child lives increases the likelihood that he or she will stay alive • To reduce childhood death rates, the world needs to focus more precisely on when the deaths occur
Risk Factors for Neonatal, Infant and Child Deaths
• Nutrition status • Household income and education of mother • Access to trained healthcare provider to attend birth and provide counseling • Water quality and sanitation
The Cost and Consequences of Child Morbidity and Mortality
• High costs of caring for a sick child • Potential long-‐term disability • Poor school attendance and performance
Addressing Key Challenges in Child Health
• Progress has been largely between 1 and 5 years; very little has been made in reducing the death rate of neonates • Insufficient progress in sub-‐Saharan Africa and South Asia • Low-‐cost, highly effective interventions are not being implemented where they are needed most
Addressing Key Challenges in Child Health
Critical Child Health Interventions • Ensuring nutrition and health of the mother and mother-‐to-‐be • Essential newborn care, extra care for small babies, and emergency care for newborns • Preventing and managing diarrhea with hygiene, proper nutrition, measles vaccinations, and ORT • Basic vaccinations
Addressing Key Challenges in Child Health
Community-‐Based Approaches to Improving Child Health
• Women’s groups to raise awareness of maternal, fetal, and neonatal issues • Community-‐based promotion of hygiene, umbilical cord care, and keeping the baby warm • https://www.ted.com/talks/myriam_sidibe_the_simple_power_of_h and_washing
Addressing Key Challenges in Child Health
Integrated Management of Childhood Illness
• Integrated healthcare approach for children because of many interrelated factors • Healthcare workers trained at all levels, particularly home and community-‐based
